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Prior Authorization Rn Jobs in Pittsburgh, PA (NOW HIRING)

Excela Health

RN SUBSIDIARY - UROLOGY

Greensburg, PA · On-site

Job Summary/Overall Object i ves The RN Subsidiary will perform direct patient care activities such ... Obtain prior authorizations and/or assist with indigent programs per physician order based on the ...

Excela Health

RN SUBSIDIARY - UROLOGY

Greensburg, PA

Job Summary/Overall Object i ves The RN Subsidiary will perform direct patient care activities such ... Obtain prior authorizations and/or assist with indigent programs per physician order based on the ...

AHN Healthcare

Hospice Registered Nurse

Mars, PA · On-site

NOTICE : * Successful completion of a drug screen prior to employment is part of our background ... By submitting your application, you are confirming that you are legally authorized to work in the ...

AHN Healthcare

Hospice Registered Nurse

Coraopolis, PA · On-site

NOTICE : * Successful completion of a drug screen prior to employment is part of our background ... By submitting your application, you are confirming that you are legally authorized to work in the ...

AHN Healthcare

Hospice Registered Nurse

Butler, PA · On-site

NOTICE : * Successful completion of a drug screen prior to employment is part of our background ... By submitting your application, you are confirming that you are legally authorized to work in the ...

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Showing results 21-40

All JobsPrior Authorization Rn JobsPrior Authorization Rn Jobs in Pittsburgh, PA

Prior Authorization Rn information

See Pittsburgh, PA salary details

$7

$41

$70

How much do prior authorization rn jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for prior authorization rn in Pittsburgh, PA is $41.01, according to ZipRecruiter salary data. Most workers in this role earn between $30.58 and $48.56 per hour, depending on experience, location, and employer.

What is the difference between Prior Authorization Rn vs Medical Coder?

AspectPrior Authorization RnMedical Coder
CredentialsRN license, possibly certifications in case management or utilization reviewCertification in coding (CPC, CCS), no RN license required
Work EnvironmentHospitals, insurance companies, healthcare facilitiesMedical offices, hospitals, insurance companies
Primary ResponsibilitiesReviewing and obtaining prior authorizations for treatments and proceduresTranslating medical records into coded data for billing and documentation

While both roles are integral to healthcare administration, the Prior Authorization RN focuses on obtaining approvals for patient care, requiring nursing credentials and clinical knowledge. In contrast, Medical Coders specialize in coding medical records for billing, emphasizing coding certifications. Understanding these differences helps healthcare professionals and job seekers identify the right career path or job opportunity.

What are the key skills and qualifications needed to thrive as a Prior Authorization RN, and why are they important?

To thrive as a Prior Authorization RN, you need a current RN license, strong clinical assessment skills, and a solid understanding of insurance guidelines and medical necessity criteria. Familiarity with utilization management software, electronic health records (EHRs), and payer-specific authorization systems is essential. Exceptional attention to detail, critical thinking, and effective communication help you advocate for patients and collaborate with healthcare providers and insurers. These skills ensure the efficient processing of authorizations, reduce delays in care, and support patients in receiving appropriate treatments.

What does a Prior Authorization RN do?

A prior authorization RN is a registered nurse who assesses applications for specific treatments, medical procedures, and medications. In this job, you review each request for medical coverage and determine the necessity or potential benefits of the treatment or medicine. You assess patient information and other factors to decide whether or not to authorize coverage. Your duties as a prior authorization RN also include reviewing denials of benefits and seeking additional information that could alter the initial decision. You document your findings for each case and present the evidence along with your decision. It is your job to review the case for each patient thoroughly while following all government regulations and healthcare provider policies.

What are some common challenges faced by Prior Authorization RNs, and how can they be addressed?

Prior Authorization RNs often navigate complex insurance guidelines and manage high volumes of requests, which can be challenging due to frequent policy updates and tight timelines. Staying organized, maintaining up-to-date knowledge of payer requirements, and leveraging electronic health record (EHR) systems can help streamline the process. Collaboration with providers and insurance representatives, as well as ongoing training, are essential for efficiently resolving issues and ensuring timely patient care.

What is a Prior Authorization RN?

A Prior Authorization RN is a registered nurse who specializes in reviewing and processing prior authorization requests for medical procedures, medications, or treatments. They evaluate clinical documentation to determine if requests meet insurance or regulatory criteria and often serve as a liaison between healthcare providers, patients, and insurance companies. Their role helps ensure that care is medically necessary and covered by the patient's health plan, streamlining access to important healthcare services while controlling costs.
More about Prior Authorization Rn jobs
What are the most commonly searched types of Prior Authorization Rn jobs in Pittsburgh, PA? The most popular types of Prior Authorization Rn jobs in Pittsburgh, PA are:
What are popular job titles related to Prior Authorization Rn jobs in Pittsburgh, PA? For Prior Authorization Rn jobs in Pittsburgh, PA, the most frequently searched job titles are:
What job categories do people searching Prior Authorization Rn jobs in Pittsburgh, PA look for? The top searched job categories for Prior Authorization Rn jobs in Pittsburgh, PA are:
What cities near Pittsburgh, PA are hiring for Prior Authorization Rn jobs? Cities near Pittsburgh, PA with the most Prior Authorization Rn job openings:
Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Pittsburgh, PA as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 19% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $85,303 per year, or $41 per hour.

RN SUBSIDIARY - UROLOGY

Excela Health

Greensburg, PA • On-site

Full-time

Re-posted 22 days ago

Job description

*****$5,000 sign-on bonus*****
Job Summary/Overall Objectives
The RN Subsidiary will perform direct patient care activities such as lab tests, treatments, and medication administration. These are performed under the direction of the physician in preparation for the patient's examination and treatment. RN will utilize nursing process to assess patient's condition and direct to the appropriate level of care using internal and external resources. Carry out clerical activities. Quality control activities, performance improvement initiatives, etc. in order to support the physician and practice as assigned.
Essential Job Functions
  • Deliver direct and indirect patient care in accordance with the RN Practice Act, hospital, and/or physician practice policies, procedures, protocols and other professional standards of care.
  • Collect patient health care data, including VS, weight, chief complaint and pain assessment focusing on the physical, psychosocial, age, cultural and spiritual needs for the patient.
  • Complete initial assessment of the patient's health history, learning needs and barriers, physical, psychosocial, cultural and spiritual needs and reassess annually.
  • Involve the patient/family and other healthcare professionals when appropriate.
  • Complete patient care treatments/testing as ordered by the physician.
  • Administer medications/immunizations using appropriate routes and techniques specific to age of the patient.
  • Comply with completeness, accuracy and timeliness of documentation.
  • Provide education and instruction, within their scope of practice, to patients and families.
  • Assess the patient's readiness to learn, educational needs and educational barriers.
  • Provide educational material and/or instruction based on assessed needs.
  • Document all education/instruction provided including topic, individual provided to and understanding.
  • Maintain collaborative relationship with physicians to achieve desired patient outcomes.
  • Prepare patients for examinations, treatments, and procedures.
  • Assist the physician with treatments and procedures as requested.
  • Provide for patient safety in compliance with hospital and physician practice policies.
  • Utilize two forms of patient identification before implementing any form of patient care.
  • Label all patient specimens with identifiers per policy.
  • Use patient identifiers on all written documentation, including notes and point of care testing results.
  • Assist in compliance with all regulatory agency requirements.
  • Adhere to infection control process, including standard precautions, to reduce the risk of acquiring or transmitting infections.
  • Participate in non-punitive medication reporting.
  • Demonstrate leadership by utilizing the concepts inherent to the practice of professional nursing.
  • Demonstrate an ability to solve problems independently and seek assistance from immediate supervisor when appropriate.
  • Maintain accountability for actions taken.
  • Delegate patient care appropriately.
  • Effectively function as a resource person.
  • Act as a patient advocate.
  • Perform effectively in the role of preceptor/mentor to new hires and/or students.
  • Assist in maintaining/decreasing organizational/departmental costs.
  • Coordinate communication between patients/families and physician practice, pharmacies, specialists and insurance carriers.
  • Provide advise based on protocols and physician instructions and direct patients to the appropriate level of care.
  • Facilitate patient's access to prescription refills based on physician order.
  • Obtain prior authorizations and/or assist with indigent programs per physician order based on the patient's financial status or insurance coverage.
  • Support performance improvement initiatives within the physician practice.
  • Assist in data collection as directed by the manager/physician.
  • Incorporate into practice performance improvement initiatives that have been implemented.
  • Maintain the environment of care.
  • Ensure that supplies in patient care areas are replenished daily.
  • Consistently maintains a clean safe environment.
  • Follow policies pertaining to daily/weekly/monthly quality control for refrigerator temperature, and equipment controls.
  • Perform POC testing as ordered by the physician.
  • Complete all quality control testing per policy and manufacturing guidelines.
  • Use two patient identifiers, name and DOB, prior to testing.
  • Follow appropriate procedures when collecting patient specimens.
  • Accurately record patient test results on appropriate result form and testing log.
  • Identify results that are out of acceptable range and follow up prior to performing patient testing.
  • Prepare forms, copy records and respond to requests per policies and procedures.
  • Assist in maintaining the patient's record to facilitate filing and retrieval of information.
  • Participate in staff education.
  • Perform other duties as assigned.
  • Other duties as assigned.

Competency and Experience [Knowledge, Skills and Abilities]
Required Qualifications/Experience
  • Graduate of an accredited Nursing Program required.

  • Strong leadership ability, good organizational skills, independent and critical thinking skills, sound judgment, and knowledge of legal aspects and liability of nursing practice.
  • Strong ability to communicate complex and/or controversial topics and concepts to a wide and diverse audience.

Preferred Qualifications/Experience
  • Bachelor's Degree in Nursing preferred.
  • Previous experience in an outpatient office setting.
  • Experience in Healthcare setting.

License, Certification & Clearances
  • Current licensure to practice as a Registered Nurse in the State of Pennsylvania required.
  • Current Basic Life Support (BLS) approved curriculum of the American Heart Association (CPR and AED) program required.

  • Act 33 with renewal
  • Act 34 with renewal
  • Act 73 Clearances

Position Type/Expected Hours of Work
  • Incumbent will be scheduled based on operational need (rotate shifts, standby, on-call, etc.).
  • Travel may be expected locally between System locations.

Equal Employment Opportunity
Independence Health and its affiliated companies are Equal Opportunity Employers. It is their policy to prohibit discrimination of any type and to afford equal employment opportunities to employees and applicants without regard to race, color, religion, sex, sexual orientation, national origin, age, marital status, disability, veteran status, or genetic information, or any other classification protected by law. Independence Health and its affiliated companies will comply with all applicable laws and regulations.
Disclaimer
This job description is not designed to contain a comprehensive listing of all activities, duties or responsibilities that are required of the employee. Moreover, duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.
Work Environment
Effective March 2020 or during pandemic: goggles, face shield and mask are required according to CDC guidelines
When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required.
Essential - Absolute Necessity.
Marginal - Minimal Necessity.
Constantly - 5.5 to 8 hours or more or 200 reps/shift.
Frequently - 2.5 to 5.5 hours or more or 32-200 reps/shift.
Occasionally - 0.25 to 2.5 hours or 2-32 reps/shift.
Rarely - Less than 0.25 hours or less than 2 reps/shift.
Physical Condition
Essential
Marginal
Constantly
Frequently
Occasionally
Rarely
Never
Extreme Heat
x
x
Extreme Cold
x
x
Heights
x
x
Confined Spaces
x
x
Extreme Noise(>85dB)
x
x
Mechanical Hazards
x
x
Use of Vibrating Tools
x
Operates Vehicle (company)
x
x
Operates Heavy Equipment
x
Use of Lifting/Transfer Devices
x
x
Rotates All Shifts
x
x
8 Hours Shifts
x
x
10-12 Hours Shifts
x
x
On-Call
Overtime(+8/hrs/shift; 40/hr/wk)
x
x
Travel Between Sites
x
x
Direct Patient Care
x
x
Respirator Protective Equipment
x
x
Eye Protection
x
x
Head Protection (hard hat)
x
Hearing Protection
x
x
Hand Protection
x
x
Feet, Toe Protection
x
x
Body Protection
x
x
Latex Exposure
x
x
Solvent Exposure
x
x
Paint (direct use) Exposure
x
Dust (sanding) Exposure
x
Ethylene Oxide Exposure
x
Cytotoxic (Chemo) Exposure
x
x
Blood/Body Fluid Exposure
x
Chemicals (direct use) Exposure
x
Mist Exposure
x
Wax Stripper (direct use)
x
Non-Ionizing Radiation Exposure
x
Ionizing Radiation Exposure
x
Laser Exposure
x
Physical Demands
When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required.
Essential - Absolute Necessity.
Marginal - Minimal Necessity.
Constantly - 5.5 to 8 hours or more or 200 reps/shift.
Frequently - 2.5 to 5.5 hours or more or 32-200 reps/shift.
Occasionally - 0.25 to 2.5 hours or 2-32 reps/shift.
Rarely - Less than 0.25 hours or less than 2 reps/shift.
Physical Condition
Essential
Marginal
Constantly
Frequently
Occasionally
Rarely
Never
Bending (Stooping)
x
x
Sitting
x
x
Walking
x
x
Climbing Stairs
x
x
Climbing Ladders
x
Standing
x
x
Kneeling
x
x
Squatting (Crouching)
x
x
Twisting/Turning
x
x
Keyboard/Computer Operation
x
x
Gross Grasp
x
x
Fine Finger Manipulation
x
x
Hand/Arm Coordination
x
x
Pushing/Pulling(lbs. of force)
x
x
Carry
x
x
Transfer/Push/Pull Patients
x
x
Seeing Near w/Acuity
x
x
Feeling (Sensation)
x
x
Color Vision
x
x
Hearing Clearly
x
x
Pulling/Pushing Objects Overhead
x
Reaching Above Shoulder Level
x
x
Reaching Forward
x
x
Lifting Floor to Knuckle
=<20
x
Lifting Seat Pan to Knuckle
x
Lifting Knuckle to Shoulder
x
Lifting Shoulder to Overhead
x
When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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